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July 3, 2017

Prospect Mortgage Company agreed to pay roughly $4 million to settle charges of violating the False Claims Act stemming from Prospect’s participation in the Direct Endorsement Lender Program administered by the Federal Housing Administration and Department of Housing and Urban Development.  The government alleged Prospect falsely certified compliance with critical underwriting and quality control requirements when originating loans insured by the FHA and HUD resulting in substantial losses to the government when the loans defaulted and ripened into claims by Prospect for insurance payments from the government.  DOJ (NDGA)

Tagged in: FCA Federal, Housing and Mortgage Fraud,

June 30, 2017

Charlotte-Mecklenburg Hospital Authority (dba Carolinas Healthcare System) agreed to pay $6.5 million to resolve charges it violated the False Claims Act by “upcoding” claims for urine drug tests in order to receive higher payment than allowed for the tests.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Mark McGuire, a former laboratory director for CHS.  He will receive a whistleblower award of roughly $1.4 million from the proceeds of the government's recovery.  DOJ (WDNC)

Tagged in: FCA Federal, Healthcare Fraud, Hospital Fraud, Upcoding, Whistleblower Case, Whistleblower Rewards,

June 29, 2017

Innovative Therapies, Inc. and its parent company Cardinal Health, Inc. agreed to pay roughly $2.7 million to settle charges they violated the False Claims Act by submitting false claims to Medicare through their marketing of certain negative pressure wound treatment devices as durable medical equipment when they knew these devices did not have the expected life of a durable device.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former ITI employee.  The whistleblower will receive an award of $488,700 from the proceeds of the government's recovery.  DOJ (MDTN)

Tagged in: FCA Federal, Healthcare Fraud, Medical Devices and DME, Medicare, Whistleblower Case, Whistleblower Rewards,

June 28, 2017

PAMC Ltd. and Pacific Alliance Medical Center Inc., which together own and operate Pacific Alliance Medical Center, an acute care hospital located in Los Angeles, agreed to pay $42 million to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians.  These relationships took the form of (1) arrangements under which the defendants allegedly paid above-market rates to rent office space in physicians’ offices, and (2) marketing arrangements that allegedly provided undue benefit to physicians’ practices.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Paul Chan, who was employed as a manager by one of the defendants.  He will receive a whistleblower award of more than $9.2 million from the proceeds of the government's recovery.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

June 28, 2017

Charles G. Landry, D.O. agreed to pay $133,464 to resolve allegations he violated the False Claims Act by knowingly submitting claims for certain evaluation and management services not eligible for Medicare payment.  DOJ (DME)

Tagged in: FCA Federal, Medicare,

June 27, 2017

Dr. Anindya Sen, owner of Tennessee-based East Tennessee Cancer & Blood Center and East Tennessee Hematology Oncology and Internal Medicine, and his wife Patricia Posey Sen, agreed to pay $1.2 million to resolve charges they violated the False Claims Act by billing Medicare and Tennessee Medicaid for non-FDA approved anticancer and infusion drugs manufactured in foreign countries.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Provider Fraud,

June 26, 2017

AMI Monitoring Inc. (aka Spectocor), its owner Joseph Bogdan, Medi-Lynx Cardiac Monitoring LLC, and Medicalgorithmics SA, the current majority owner of Medi-Lynx, agreed to pay roughly $13.5 million to resolve allegations they violated the False Claims Act by billing Medicare for higher and more expensive levels of cardiac monitoring services than requested by the ordering physicians.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Spectocor sales manager Eben Steele.  He will receive a whistleblower award of roughly $2.4 million from the proceeds of the government's recovery.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Provider Fraud, Upcoding, Whistleblower Case, Whistleblower Rewards,

July 24, 2017

Myra Gross, a former patient of Dr. James Norman, owner of Florida-based Norman Parathyroid Center, and her husband Dr. David Gross, will receive a whistleblower award of roughly $600,000 from the $4 million Dr. Norman agreed to pay to resolve allegations he violated the False Claims Act by billing Medicare for pre-operative examination services for which he had already received payment from the government.  DOJ (MDFL)

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Whistleblower Case, Whistleblower Rewards,

July 24, 2017

New Jersey-based pharmaceutical manufacturer Celgene Corp. agreed to pay $280 million to settle charges of violating the False Claims Act by promoting two cancer treatment drugs -- Thalomid and Revlimid -- for uses not approved by the FDA.  The allegations included the use of false and misleading statements about the drugs, and paying kickbacks to physicians to induce them to prescribe the drugs.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Celgene sales manager Beverly Brown.  She will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (CDCA)

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Off-Label and Unapproved Use, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

July 17, 2017

Former Olympia Therapy Inc. employee Vladimir Trakhter and former Tridia Hospice Care Inc. employees Paula Bourne and La’Tasha Goodwin will collectively receive a whistleblower award of more than $3.6 million from the roughly $19.5 million Olympia, Tridia and Foundations Health Solutions Inc. agreed to pay to resolve allegations they violated the False Claims Act by submitting to Medicare claims for medically unnecessary rehabilitation therapy services and for hospice services to patients not eligible for the Medicare benefit, and by soliciting and receiving kickbacks to refer patients from their skilled nursing facilities to home health care provider Amber Home Care LLC.

Tagged in: Anti-Kickback and Stark, FCA Federal, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

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